Organization
MICHAEL J. WHITTED DDS PC
Active
Other names
Michael J. Whitted & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WHITTED DDS (OWNER/DENTIST)
(847) 695-5100
Entity
Organization
Contact information
Practice address
1950 GYORR AVE, SOUTH ELGIN, IL 60177-2289
(847) 695-5100
(847) 695-5180
Mailing address
1950 GYORR AVE, SOUTH ELGIN, IL 60177-2289
(847) 695-5100
(847) 695-5180
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.026132
IL
1223G0001X
General Practice Dentistry
019.027885
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
319.018217
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750393989
NPI
IL
Enumeration date
02/03/2014
Last updated
02/03/2014
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